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Query: UMLS:C0027497 (nausea)
 23,468 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The efficacy, side effects, and biologic actions of the progestogen-only minipills marketed since February 1973 are reviewed. The preparations are: 350 mcg norethisterone (Micronor Ortho), 30 mcg d-norgestrel (Microlut Schering and Microval Wyeth), and 500 mcg lynestrenol (Exluton Organon). The efficacy of these drugs depends on motivation: Pearl indexes vary from 1.17-3.72 for norethisterone, .9-4.4 for d-norgestrel, and .8- 2.2 for lynestrenol. Some physiologic effects of minipills possibly related to their mode of action are impermeable cervical mucus and low levels of progesterone, pregnanediol, estrogen, and LH. The side effects influencing dropout most are spotting (40-55% in the first cycle), polymenorrhea (about 10%), and amenorrhea (about 5-10%). Some transient estrogenic side effects such as nausea, headaches, and breast pain may be due to estrogenic metabolites from lynestrenol and norethisterone. None of the severe estrogenic side effects, such as thrombophlebitis and impaired glucose tolerance and liver function, are characteristic of progestogen pills.
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PMID:[Minipill as the new contraceptive method]. 481 42

The contraceptive effect of Depo-Provera or medroxyprogesterone acetate, a long-acting injectable progestogen, has been mainly attributed to its ability to prevent ovulation through its action on the hypothalamic pituitary axis, reducing the levels of plasma gonadotropin, progesterone, and estradiol, and suppressing the midcycle surge of luteinizing hormone. Its other contraceptive effects are thickening of the cervical mucus, causing a barrier to spermatozoa, alteration in tubal ovum transport, and atrophy of the endometrium. A standard dose of 150 mg injected every 3 months is as effective as the combined oral pill and more effective than the progestogen-only pill or IUD. Contraindications to use are thrombophlebitis, liver dysfunctions, suspected breast or genital malignancy, and abnormal uterine bleeding. Reported discontinuation rates range from 7-80%. The World Health Organization (1977) reported a gross cumulative discontinuation rate of 23.4/100 women years in 8 centers. Depo-Provera has a long list of short-term (menstrual disorders, fluid retention, nausea, hair loss, and others) and long-term (delayed fertility return, congenital abnormalities, cancer others) disorders. Its advantages include: 1) convenience, 2) effectiveness, 3) no risk of infection or other side effects of the coil, 4) none of proven side effects or long-term hazards of estrogen, and 5) no inhibition of lactation. The safety of Depo-Provera has been a controversial issue which led to its banning in the U.S. Its carcinogenic potential has been reported in clinical trials with animals. Its greatest disadvantage is that it takes control of a woman's fertility firmly out of her hands into those of the doctor. Depo-Provera should not be used except as an absolute last resort. It should not be used as a long-term contraceptive in this country, and research monies should instead be channeled into the development of a safe, reliable contraceptive with no systemic side effects.
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PMID:Depo-Provera: an injectable contraceptive. 645 20

Sixteen patients with bronchopulmonary infection received 500 mg erythromycin lactobionate by intravenous infusion every 8 h for 2 days. The duration of infusion was either 30 (8 patients) or 60 min (8 patients). An inline filterset (0.22 micrometer) was included in the intravenous administration set in 4 patients of each infusion group. Serum erythromycin levels were obtained before and at various times for 8 h after the first and fourth doses and before and immediately after the other doses. The incidence and severity of venous irritation and gastrointestinal side-effects were assessed. Mean (S.D.) peak erythromycin levels for the 30 min infusion were 26.31 (6.89) micrograms/ml (first dose) and 26.85 (6.11) micrograms/ml (fourth dose) and for the 60 min infusions, 23.96 (7.91) micrograms/ml (first dose) and 23.65 (6.55) micrograms/ml (fourth dose). Venous irritation was experienced by 12 patients, ranging from localized discomfort to thrombophlebitis, but the severity was significantly reduced by inline filtration (P less than 0.005). Gastrointestinal side-effects were reported by 8 patients and 1 patient withdrew because of severe abdominal pain and nausea. These symptoms were usually relieved by spasmolytic agents and possibly could be explained by high concentrations reaching the gut wall either by biliary excretion or direct transport from blood and stimulating smooth muscle motility.
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PMID:Study of serum levels, venous irritation and gastrointestinal side-effects with intravenous erythromycin lactobionate in patients with bronchopulmonary infection. 664 16

Results are presented of an evaluation of the contraceptive efficacy, cycle control, and tolerance of a low dose triphasic pill, Trigynon, used by 353 reproductive-aged women for a total of 1668 cycles. 20 physicians in different Belgian centers recruited and followed the women. Average weight of the patients was 56.8 kg, average age was 24.8 years, average parity was 1.07, and 1/3 smoked. None had any medical condition contraindicating the use of the preparation. 156 of the women had never used contraception, 163 had used combined pills, 4 had used injectables, 6 had used progestin-only minipills, 21 had used IUDs, and 22 had used other methods. 2.5% of the patients forgot to take at least 1 pill in a typical cycle. No pregnancies were imputed to forgetting, but 3 pregnancies occurred during the study: 1 already established but not recognized at the start of treatment, 1 in a woman taking antituberculosis drugs, and 1 in a patient suffering an attack of dysentery. Almost 90% of patients had regular cycles of 28 days with treatment, compared to only 57.5% before treatment. The duration and quantity of bleeding were significantly decreased. Compared to the last pretreatment cycle, the 3rd and 6th cycles with Trigynon showed a decrease in percentage of patients complaining of dysmenorrhea, nervousness, headaches, breast tenderness, nausea, vomiting, decreased libido, depression, thrombophlebitis, and edema. The percentage complaining of acne and vertigo increased slightly at 3 months and then declined to below pretreatment levels. Average weight was almost unchanged. It appears that Trigynon offers reliable protection, excellent cycle control and few side effects, and would be an appropriate contraceptive choice for most women except those with benign breast disease or hyperestrogenism.
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PMID:[Clinical evaluation of 1,668 cycles of triphasic oral contraception (Trigynon). Multicentric Belgian study]. 681 54

Thirty-four multidrug-resistant cases of Indian visceral leishmaniasis (kala-azar) were treated with amphotericin B. A complete hemogram, liver and renal function tests, determination of serum electrolyte levels, a chest radiograph, and an electrocardiogram were done before, during, and after completion of therapy. Assessment for clinical and parasitologic cure was done weekly. Thirty-one patients who completed treatment had full cure after receiving 10-15 injections at six-months follow up. One patient died of myocarditis. A febrile reaction was observed in all cases, while thrombophlebitis was found in six cases (18.75%). Anorexia, nausea, and vomiting were found in seven cases (21.88%). No significant nephrotoxicity or electrolyte disturbances were observed. It is concluded that amphotericin B is an effective second-line drug for Indian visceral leishmaniasis, but unpredictable drug-induced myocarditis remains a problem.
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PMID:Use of amphotericin B in drug-resistant cases of visceral leishmaniasis in north Bihar, India. 761 61

Infusion-related adverse events (IRAEs) such as nausea, vomiting, fever, chills, and thrombophlebitis that are associated with amphotericin B therapy often lead clinicians to prescribe a number of adjunctive pretreatment medications in an attempt to reduce the incidence and severity of these events. The purpose of this study was to determine the incidence of IRAEs during the first week of systemic amphotericin B therapy and to identify pretreatment regimens that are effective in preventing these IRAEs. Three hundred ninety-seven adult inpatients receiving amphotericin B therapy were prospectively monitored, and data regarding IRAEs and pretreatment regimens were collected. Of these patients, 282 (71%) developed at least one IRAE during the first 7 days of therapy. The IRAEs most commonly reported were fever (51% of patients) and chills (28%), followed by nausea (18%), headache (9%), and thrombophlebitis (5%). The most common regimens included diphenhydramine, a corticosteroid, acetaminophen, and heparin, administered alone or in combination with these or other drugs. Overall, common pretreatment regimens were similar in efficacy to no pretreatment in the prevention of IRAEs. Thus empirical premedication for IRAEs associated with amphotericin B cannot be routinely advocated; instead, patients should be treated when symptoms first arise and then premedicated for subsequent amphotericin B infusions.
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PMID:Pretreatment regimens for adverse events related to infusion of amphotericin B. 779 69

Twenty-two patients with supratentorial malignant gliomas were treated postoperatively with concurrent intracarotid chemotherapy and radiation therapy. There were seven women and 15 men with a median age of 56 years (range, 22-69) and median performance status (Karnofsky score) of 70 (range, 40-90). In all except two cases, histologic studies confirmed malignant glioma. All patients were irradiated with a cobalt 60 equipment. They should have received 45 Gy to the whole brain plus a 15-Gy coned-down boost to the tumor area. Chemotherapy consisted of cisplatin infusion at a dose of 60 mg/m2 on days 2, 22, and 42. Treatment was interrupted in two patients because of progressive disease and voluntary withdrawal in one patient each. In all, 63 courses of cisplatin infusion were administered, all at full dose. Two patients achieved a partial response, and nine had stable disease. Toxicities included nausea/vomiting in nine patients (41%) and transient hemiparesis, confusion, diarrhea, and thrombophlebitis in one patient each. Median time to progression was 26 weeks (range, 4-226+), and median survival was 58 weeks (range, 14-226+). In conclusion, the present study suggests that intracarotid cisplatin administered concurrently with radiation does not improve the therapeutic index in malignant gliomas.
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PMID:Concurrent radiation and intracarotid cisplatin infusion in malignant gliomas: a feasibility study. 912 86

The safety and tolerability of quinupristin/dalfopristin were assessed in both comparative and non-comparative trials (2298 quinupristin/dalfopristin-treated patients). In comparative clinical trials, the most frequent systemic adverse events related to quinupristin/dalfopristin were nausea (4.6%), diarrhoea (2.7%), vomiting (2.7%) and skin rash (2.5%). The comparator group showed similar rates, except that nausea was significantly more common (7.2%; P = 0.01). In non-comparative trials, arthralgia and myalgia were reported most frequently but were reversible upon treatment discontinuation. The renal, inner ear, cardiovascular and central nervous systems were not implicated as significant target organs for toxicity. The most frequent local adverse events related to infusion of quinupristin/dalfopristin were inflammation, pain, oedema, infusion site reaction and thrombophlebitis. Results of laboratory tests while on therapy were comparable for quinupristin/dalfopristin and comparator groups, except that increases in conjugated bilirubin of >5 x the upper limit of normal were reported in 5.5% of quinupristin/dalfopristin recipients; increases in total bilirubin of >5 x the upper limit of normal occurred in 1.5%. Comparator recipients more frequently had increases in alanine aminotransferase and alkaline phosphatase. Quinupristin/dalfopristin inhibits the cytochrome P450 3A4-mediated metabolism of drugs including midazolam, nifedipine, terfenadine and cyclosporin. Therefore, plasma drug monitoring and/or dosage reduction of these agents is prudent. Concomitant administration of drugs that can prolong the electrocardiographic QTc interval should be avoided. Quinupristin/dalfopristin is visually and chemically compatible with commonly used drugs of various classes, but it is not compatible with sodium chloride solution and certain other drugs, including some antimicrobials. Therefore, when prescribing quinupristin/dalfopristin, clinicians should be aware of the potential for peripheral venous intolerance, arthralgias and myalgias, increases in conjugated bilirubin, interactions with drugs metabolized by the cytochrome P450 3A4 isoenzyme and certain physico-chemical incompatibilities. However, multiple studies have shown that the safety and tolerability of quinupristin/dalfopristin are generally favourable, and that it provides clear benefits to ill patients with severe gram-positive infections.
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PMID:Safety and tolerability of quinupristin/dalfopristin: administration guidelines. 1051 96

A 34-year-old man developed fever, headache, nausea, double vision, exophthalmus, ptosis, disturbance of vision and oculomotor nerve palsy. Magnetic resonance imaging and cerebral angiography led to the clinical diagnoses of cavernous sinus thrombophlebitis and suspicion of bacterial aneurysm of the left internal carotid artery, respectively. Peptostreptococcus was detected in blood culture analysis. He died 15 days after admission. Systemic organs showed several septic changes. In particular, the bilateral cavernous sinuses were enlarged and showed severe neutrophilic leukocyte infiltration of the walls and organization, recanalization and abscesses in thrombi. In anterior to the middle cranial fossa, abscess-forming, necrotic, hemorrhagic meningitis, purulent sphenoid sinusitis, pyogenic osteomyelitis of the sphenoid bone, suppurative encephalitis, and inflammatory necrosis of the hypophysis were seen. Based on these findings, we diagnosed the patient with cavernous sinus thrombophlebitis caused by sphenoid sinusitis.
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PMID:Cavernous sinus thrombophlebitis caused by sphenoid sinusitis--report of autopsy case. 1143 Apr 92

185 women received chlormadinone acetate (a 19-hydroxyprogesterone derivative) .5 mg daily, for 18 months. All (aged 20-40 years) were parous. 180 women were followed through 2280 cycles. Dropout rate was highest in the first cycle (44%), 4% from the sixth to the twelfth cycles, and about 1% after the thirteenth cycle. Side effects were 2%: breakthrough bleeding, amenorrhea, menorrhea, dysmenorrhea, abdominal pain pregnancy, nausea, weakness forgetfulness, giddiness and headache, burning sensation, red spots on skin, and thrombophlebitis. Breakthrough bleeding (14 cases), amenorrhea (12 cases) and weakness (8 cases) were the most frequently reported problems. Phlebitis was seen in 1 case. 40 of the 48 cases of side effects were seen before the sixth cycle. There were 3 pregnancies during the study: 1 woman was pregnant at the beginning of therapy and 2 were due to patient failure. A review of the literature followed, including a discussion on the mode of action of chlormadinone.
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PMID:Chlormadinone acetate as an oral contraceptive. 1225 95


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